Acupuncture – a critical analysis

@article{Ernst2006AcupunctureA,
  title={Acupuncture – a critical analysis},
  author={Edzard Ernst},
  journal={Journal of Internal Medicine},
  year={2006},
  volume={259}
}
  • E. Ernst
  • Published 1 February 2006
  • Medicine
  • Journal of Internal Medicine
Even though widely used in today's clinical practice, acupuncture has remained a controversial subject. Many reviews are currently available but most lack a critical stance and some are overtly promotional. The aim of this overview is to provide a balanced, critical analysis of the existing evidence. Some of the original concepts of traditional acupuncture are not supported by good scientific evidence. Several plausible theories attempt to explain how acupuncture works but none are proved… 
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284 Citations
Highly Influential Citations
12
Background Citations
103
Methods Citations
8
Results Citations
5

284 Citations

Citation Type

Citation Type

Acupuncture – a treatment to die for?
  • E. Ernst
  • Medicine
    Journal of the Royal Society of Medicine
  • 2010
TLDR
Acupuncture has been associated with more deaths than most other ‘alternative’ therapies except herbal medicine, and case reports of adverse effects after acupuncture are frequently limited through poor reporting, particularly those published in the Chinese literature.
Clinical research on acupuncture. Part 1. What have reviews of the efficacy and safety of acupuncture told us so far?
TLDR
General international agreement has emerged that acupuncture appears to be effective for postoperative dental pain, postoperative nausea and vomit, and chemotherapy-related nausea and vomiting.
Acupuncture: what does the most reliable evidence tell us?
  • E. Ernst
  • Medicine
    Journal of pain and symptom management
  • 2009
TLDR
It is concluded that Cochrane reviews of acupuncture do not suggest that this treatment is effective for a wide range of conditions, and the conditions that are most solidly backed up by evidence are chemotherapy-induced nausea/vomiting, postoperative nausea/ vomite, and idiopathic headache.
Clinical research on acupuncture. Part 2. Controlled clinical trials, an overview of their methods.
  • S. Birch
  • Medicine
    Journal of alternative and complementary medicine
  • 2004
TLDR
A list of 45 criteria important in the design, implementation, and writing up of controlled clinical acupuncture trials is developed, after examining the quality assessment criteria used in meta-analyses and systematic reviews of acupuncture, general publications on clinical trial designs and methodological considerations specific to acupuncture trials.
Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking
TLDR
Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided and establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.
Is acupuncture no more than a placebo? Extensive discussion required about possible bias.
TLDR
The present review aimed to suggest techniques to design high-quality studies, minimize the placebo effect and optimize acupuncture administration in acupuncture studies.
Acupuncture for fibromyalgia--a systematic review of randomized clinical trials.
TLDR
The notion that acupuncture is an effective symptomatic treatment for fibromyaligia is not supported by the results from rigorous clinical trials and, on the basis of this evidence, acupuncture cannot be recommended for Fibromyalgia.
How might acupuncture work? A systematic review of physiologic rationales from clinical trials
  • H. Moffet
  • Medicine
    BMC complementary and alternative medicine
  • 2006
TLDR
Many acupuncture trials fail to offer a meaningful rationale, but proposing a rationale can help investigators to develop and test a causal hypothesis, choose an appropriate control and rule out placebo effects.
Acupuncture: its evidence-base is changing.
TLDR
The results indicate that the evidence base has increased for 13 of the 26 conditions included in this comparison and the emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.
Acupuncture for Improving Chronic Back Pain, Osteoarthritis and Headache.
TLDR
Overall, acupuncture appears superior to no treatment or usual care for persons with chronic back pain, osteoarthritis, or headache, but these findings vary depending on the specific outcome and the follow-up period.
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References

SHOWING 1-10 OF 215 REFERENCES
Clinical research on acupuncture. Part 1. What have reviews of the efficacy and safety of acupuncture told us so far?
TLDR
General international agreement has emerged that acupuncture appears to be effective for postoperative dental pain, postoperative nausea and vomit, and chemotherapy-related nausea and vomiting.
Clinical research on acupuncture. Part 2. Controlled clinical trials, an overview of their methods.
  • S. Birch
  • Medicine
    Journal of alternative and complementary medicine
  • 2004
TLDR
A list of 45 criteria important in the design, implementation, and writing up of controlled clinical acupuncture trials is developed, after examining the quality assessment criteria used in meta-analyses and systematic reviews of acupuncture, general publications on clinical trial designs and methodological considerations specific to acupuncture trials.
Advancing acupuncture research.
  • A. Ahn, T. Kaptchuk
  • Psychology, Medicine
    Alternative therapies in health and medicine
  • 2005
TLDR
It is proposed that the use of "manualized" protocols in clinical trials that are linked with mechanistic studies can create a healthy dialogue between the medical and acupuncture communities and recognize the unique physiologic properties that may be found in each acupuncture style.
Effectiveness of acupuncture.
TLDR
Control trials of acupuncture show that, whereas the latter claim a 70% success rate, there is no advantage shown for acupuncture over placebo in controlled studies, which suggests that clinically, pain relief attributed to acupuncture is more likely.
Is acupuncture effective for the treatment of chronic pain? A systematic review
The Effectiveness of Acupuncture for Depression – a Systematic Review of Randomised Controlled Trials
TLDR
The evidence from controlled trials is insufficient to conclude whether acupuncture is an effective treatment for depression, but justifies further trials of electroacupuncture.
The effectiveness of acupuncture in treating acute dental pain: a systematic review
TLDR
It is concluded that acupuncture can alleviate dental pain and that future investigations should define the optimal acupuncture technique and its relative efficacy compared with conventional methods of analgesia.
Systematic reviews of complementary therapies - an annotated bibliography. Part 1: Acupuncture
TLDR
A large number of systematic reviews on acupuncture exists, and what is most obvious from these reviews is the need for well-designed, larger clinical trials.
Acupuncture/acupressure for weight reduction? A systematic review.
  • E. Ernst
  • Medicine
    Wiener klinische Wochenschrift
  • 1997
TLDR
No clear picture emerges to show that acupuncture/acupressure is effective in reducing appetite or body weight, and claims that these forms of treatment have specific effects on these conditions are therefore not based on well-performed clinical trials.
Acupuncture analgesia during surgery: a systematic review
TLDR
This review does not support the use of acupuncture as an adjunct to standard anaesthetic procedures during surgery and strong evidence exists that real acupuncture is not significantly different from placebo acupuncture.
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